DISTANCE EDUCATION
*ENROLLMENT FOR THE 2023-2024 SCHOOL YEAR IS NOW CLOSED. 
ALL INQUIRIES WILL BE CONTACTED IN JULY 2024


Please complete this form if you are interested in our distance education program.  All distance education students must be 21+ to participate. This program is only for individuals who do not have a high school diploma or equivalent. 

Fill in the fields below and someone will contact you to schedule your orientation.
Sign in to Google to save your progress. Learn more
FIRST NAME
*
LAST NAME *
ARE YOU 21 OR OLDER? *
DO YOU LIVE IN THE BUFFALO PUBLIC SCHOOL DISTRICT? *
DATE OF BIRTH  *
MM
/
DD
/
YYYY
PHONE NUMBER (include area code) *
EMAIL *
ADDRESS  *
CITY *
STATE *
ZIP CODE *
GENDER *
DO YOU HAVE AT LEAST 6 HOURS EACH WEEK TO COMPLETE ASSIGNMENTS *
ARE YOU ABLE TO ATTEND 3 HOURS OF TUTORING PER WEEK? *
WHERE DID YOU HEAR ABOUT OUR PROGRAM? *
ENROLLMENT FOR THE 2023-2024 SCHOOL YEAR IS NOW CLOSED. ALL INQUIRIES WILL BE CONTACTED IN JULY 2024

Thank you for your interest. Someone will contact you.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Buffalo Public Schools. Report Abuse